肝硬化门静脉性胆病的影像表现

The imaging features of portal biliopathy in patients with liver cirrhosis

目的:探讨肝硬化门静脉高压性胆病(PB)的MSCT及MRI表现。方法:回顾性分析16例肝硬化PB患者的MSCT及MRI表现,分析门静脉血栓导致PB的解剖位置和临床表现。结果:16例患者中门静脉海绵样变13例,其中8例合并门静脉血栓;门静脉和/或门静脉分支血栓3例。16例患者中3例表现为肝内胆管扩张,9例表现为肝外胆管及一侧肝内胆管扩张,4例表现为肝外胆管和两侧肝内胆管扩张。本组病例门静脉系统侧支循环的类型包括食道-胃底静脉曲张13例(13/16,81%)、胰腺周围静脉曲张10例(10/16,63%)和胆囊静脉曲张10例(10/16,63%)。结论:肝硬化门静脉高压患者出现肝外或肝内胆管扩张时应考虑门静脉高压性胆病的可能。

Objective：The aim of the study was to determine the imaging features of portal biliopathy （PB） in patients with liver cirrhosis. Methods：A retrospective study of 16 patients who underwent MDCT and MRI scan for PB was conduc- ted,and the anatomic and clinical features in PB patients with chronic portal vein thrombosis were analyzed. Results：Of the sixteen cases, there was portal vein cavernous transformation in 13 cases,including 8 cases with the portal vein and/or portal vein branch thrombosis. The portal vein thrombosis and/or portal vein branch thrombosis was shown in 3 eases. In addi- tion,intrahepatic bile duct dilation was shown in 3 cases, extrahepatic bile duct and single branch of intrahepatic bile duct di- lation in 9 cases,extrahepatic bile duct and two branches of intrahepatic bile duct dilation in 5 cases. As to the portal vein system collateral circulation,there were gastroesophageal varices in 13 cases, peripancreatic varices in 10 cases, and cystic vein variees in 10 cases. Conclusion：When patients with portal hypertension who have features of extra- and intrahepatic bile duct dilation, the portal biliopathy should be suspected as a possible diagnosis.